Osteomyelitis XRay


Osteomyelitis XRay, Osteomyelitis Plain Radiography, XRay in Suspected Osteomyelitis

  • Indications
  1. First line study in Osteomyelitis evaluation due to low cost and high availability
  2. Narrows Osteomyelitis differential diagnosis by ruling out other causes
    1. Metastases to bone
    2. Osteoporotic Fractures
  • Findings
  • Early
  1. Soft tissue swelling
  2. Periosteal reaction (Subperiosteal elevation)
  • Findings
  • Later
  1. Osteolysis with cortical loss and bony destruction
    1. Typical appearance is the "rat bite" (lytic lesions) of destroyed bony cortex
    2. Lytic changes not visualized until 50-75% of bone matrix is destroyed
  2. Sequestra (islands of necrotic bone)
  3. Bone abscess (Brodie's abscess)
  • Limitations
  1. Bone changes lag infection by 10-20 days
  2. XRay changes not seen until 40-70% bone resorbed
  3. Repeat XRay at 2 week intervals